staph infections of sweat glands and glabrous skin

Question 1

whay is the disease caused of the sweat glands linked w/ staph aureus

Answer 1

hiradenitis suppurativa

Question 2

alt name for hiradenitis suppurativa

Answer 2

acne inversa even though its not a form of acne and responds to some acne rx

Question 3

what causes hiradenitis suppurativa

Answer 3

unknown 
risk factors
-genetic
-obesity
-smoking
-hormones

Question 4

what suggests a hormonal link to hiradenitis suppurativa

Answer 4

usually presents after puberty and worsens around menstruation in woman

Question 5

what is hiradenitis suppurativa

Answer 5

condition characterized by boils (abscesses) of the apocrine glands d/2/ comedone occlusion and bacterial buildup

Question 6

hiradenitis suppurativa sx

Answer 6

multiple painful boils
site

-armpits. genitals, anus, neck

boils can ooze pus and have foul smell

hyperpigmentation of affected areas

Question 7

dg of hiradenitis suppurativa

Answer 7

phyisical exam
history
blood test
culture

Question 8

hiradenitis suppurativa rx

Answer 8

topical/ oral antibiotics
risk factor reductio m
retinoids
anti androgen therapy
immunosuppressants 

• weight loss
  -ceas smoking
  -proper hygiene
  =avoid trauma to characteristic sites
  -

Question 9

name of staph disease of glabrous skin

Answer 9

Staphylococcal scalded skin syndrome (SSSS)

Question 10

define (SSSS)

Answer 10

disease charac by red blisters resmebling a scald

Question 11

PP of (SSSS)

Answer 11

staph aureus releases epidermolytic toxin A and
epidermolytic toxin B

toxins break up desmosomes and skin cells are unable to adhere to each other

Question 12

what molecule in desmosomes is attacked in SSSS

Answer 12

desmoglein 1

Question 13

pop at risk of SSSS

Answer 13

children under 5

immonucompromised

renaal failure pt
- toxins are cleared by the kidneys

Question 14

why are neonates MOST at risk

Answer 14

they lack specific immunity to the staph epidermolytic toxins

immature renal system

Question 15

progression of SSSS

Answer 15

1st: fever and erythema a
2nd: after 24hrs: fluid filled blisters
3rd: rupture leaving scaleded like skin behind

Question 16

SSSS lesion described

Answer 16

tissue paper wrinkled skin

red moist tender skin on blister rupture

sites

• begins at armpits and groin
• orifices: nose anad ears
• spreads to arms and legs

Question 17

SSSS dg

Answer 17

positive nikolsky
tzanck smear
biopsy- shows intradermal cleavage
culture

Question 18

What is a tzanck smear

Answer 18

scraping of an ulcer base to look for Tzanck cells

Question 19

what are tzanck cells

Answer 19

degenerated epithelial call from keratin later thays disconnected from other cells . present as hyperchromatic epithelial cells lying free in the vesicular space d/2 acantholysis

Question 20

what is acantholysis

Answer 20

loss of intercellular connections, such as desmosomes, resulting in loss of cohesion between keratinocytes, seen in diseases

Question 21

what diseases are tzanck cells seen

Answer 21

SSSS
pemphigus vulgaris (NOT BULLOUS)
Chicken pox
herpes zoster

Question 22

rx of SSSS

Answer 22

IV flucloxacillin

vancomycin if caused by MRSA

Question 23

why is flucloxacillin used in SSSS

Answer 23

its penicillinase resistant

Question 24

suppurative rx of SSSS

Answer 24

petroleium jelly to moisturise skin

maintail water electrolyte balance

paracetomol for pain and fever

incuvation for neonates

Question 25

complications

Answer 25

sepsis
cellulitis
death

Question 26

prognosis w/ rx

Answer 26

heals in 5-7 days